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An aerial survey crew failed to use oxygen and flew past four nearby airports instead of diverting when they were affected by fumes, the ATSB has found.
The crew of the Cessna 404 Titan, VH-LAD, chose to fly back to Emerald Airport 200km away when they detected the fumes in the cabin on 11 April 2024, which caused symptoms including headaches, dizziness and nausea.
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According to the ATSB’s report, the crew smelled the fumes 20 minutes into their survey run near Moranbah, Queensland.
As nearby Moranbah Airport was a private airport and would have required the pilot to declare an emergency, which the crew did not feel was warranted, they opted instead to return to Emerald; however, they did not appear to consider diversions to Dysart, Clermont or Capella airports either, which were also on the way.
“The decision to cancel the survey was prudent, but flying back to Emerald, rather than diverting to closer suitable airports, exposed the crew to the fumes for longer than necessary and may have worsened the impact,” said ATSB director of transport safety Stuart Macleod.
“When encountering a fumes event, don’t hesitate to use supplemental oxygen, use all available means to ventilate the cabin, and consider diverting to reduce the airborne exposure time.
“In addition, communicate the presence of fumes and any symptoms to air traffic control at the first available opportunity; this can maximise the assistance available to you both in the air and on the ground.”
Additionally, the crew did not use supplemental oxygen, though they did open windows, vents, and cabin doors.
At one point during the return, the pilot advised Brisbane Centre air traffic control they planned to conduct a precautionary landing in a field, and descended at a maximum rate of over 2,600 ft/minute.
After levelling off at around 2,200 ft, the pilot assessed they were feeling better and opted to proceed to Emerald.
The aircraft landed safely at Emerald Airport about 90 minutes after the fumes were initially noticed. All three crew members were transferred to the hospital for treatment.
Despite extensive ground and in-flight examination of the aircraft after the occurrence, the source of the fumes could not be established.
Since the occurrence, the operator has issued a mandatory requirement for pilots on all flights to secure the onboard oxygen equipment within seated reach of the pilot and issued guidance to all pilots to use supplementary oxygen in conditions such as those encountered during this incident.
Stewart Smith
says:I am struck by this sentence in the article:
“Despite extensive ground and in-flight examination of the aircraft after the occurrence, the source of the fumes could not be established.”
Wow. How is that possible? I would not like to be the next crew or passengers on this plane that had NOT been fixed!